Palliative care: Do not leave those suffering behind

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A tenet of the development of mature, civilised societies is a nature of inclusiveness in dealing with those with needs and their access to care.

In a social context, this usually applies to those with educational needs, poverty, employment and many others.

In the area of healthcare, a common example is the development of universal healthcare and the right of access to maternal health, child vaccination programmes and public health.

Yet, not a day passes where examples of individual and family suffering are brought up in pages of our newspapers or social media.

Globally, it is recognised that in developing the Sustainable Development Goals (the United Nations Development Programme’s universal call to action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity), no one should be left behind.

This has also been accepted by the palliative care community as a focus of care for this year’s World Hospice and Palliative Care Day, which falls on the second Saturday of October each year.

Health is a concern for everyone. We care for our own health and the health of our family and friends.

The government, through the Ministry of Health and the private sector, has established hospitals and clinics.

However, faced with an ageing population, Malaysians will increasingly suffer from the ravages of the spectrum of non-communicable diseases (NCDs) such as cancer, cardiovascular diseases, kidney failure and many others.

Cancer remains an emotive subject. It brings connotations of pain and suffering, with an association of suffering and death.

The treatment itself, such as chemotherapy and radiotherapy, is preconceived to bring suffering to the patient.

At least for some cancer patients, their suffering may be alleviated through the inclusion of palliative care as part of the care they receive.

There are two aspects of hope for cancer patients. Cancer, when diagnosed early and with certain types, has a significant cure rate.

And secondly, the availability of palliative care has enabled patients to have better pain relief as well as better quality of life.

In recent years, there is increasing evidence that the integration of palliative care to cancer care improves survival.

Amidst the public and policy maker concerns about the prevalence of cancer, many more in Malaysia suffer from chronic cardiovascular disease, lung and kidney failure and other chronic diseases.

For these patients, the two aspects of hope identified through cancer, is less clear. A curative goal for these patients is less clear and though there are several treatment options, these patients are expected to mainly survive multiple episodes of illness necessitating hospital visits, but gradually succumbing to their illness.

These patients often suffer from pain and other symptoms as much, if not more, than cancer patients. Yet for them, access to good symptom control and support through palliative care may be denied as most still assume that palliative care is only for cancer patients.

Why should cancer patients receive better care than those suffering from the same symptoms but caused by other illnesses?

In the Palliative Care Needs Analysis in 2016, the major need for palliative care is mainly by patients with cardiovascular illness.

Yet, many patients with cardiovascular and other chronic diseases are not aware that palliative care may alleviate their suffering.

Similarly, their doctors are also not aware that there are other options that may assist in the care of their patients.

If we are truly a caring society and have a framework for inclusiveness, access to care for those who are suffering needs to be addressed as a matter of urgency.

The knowledge and services may already be available in some areas but the willingness to engage may not.

Do not leave those suffering behind … they may be you or your loved one, one day.